AB0767 Comparison of the clinical-laboratory remission and the ASAS partial remission in patients with early axial spondyloarthritis
Authors: D. Timokhina, T. Dubinina, A. Demina, O. Krichevskaya, S. Erdes
Journal: Annals of the Rheumatic Diseases (2022)

Background The main goal of “T2T” strategy for spondyloarthritis (SpA) is to achieve clinical remission or inactive disease. In 2001, the ASAS formulated criteria for partial remission [1], and the Russian Expert Group for Study of SpA (ExSpA) in 2018 identified clinical-laboratory remission (absence of clinical manifestations of the disease that persists for 6 months with normal values ​​of CRP and ESR), MRI remission and complete remission (a combination of clinical-laboratory and MRI remission) [2]. Objectives to compare the ASAS criteria for partial remission and the clinical-laboratory remission in patients with early axial SpA (axSpA) at 3 rd year of follow-up. Methods The study included patients with early axSpA (ASAS criteria 2009 with inflammation back pain duration less than 5 years) from the CORSAR cohort (Early SpondyloArthritis Cohort), formed at the V.A. Nasonova Research Institute of Rheumatology. The cohort includes 175 patients with axSpA. The analysis included 66 patients followed for at least 3 years, of which 37 (56%) were men and 29 (44%) - women. The average age of patients was 31.5 (5.7) years, the average duration of the disease was 22.1 (17.0) months, 63 (95.4%) patients were HLA B27 positive. The criteria for clinical-laboratory remission include the following indicators (at least during 6 month): ASDAS≤1,3, BASDAI ≤1,0, morning stiffness&lt;30 min., absence of swollen joints, absence of enthesitis, nocturnal pain ≤1,0 (NRS), spinal pain≤1,0 (NRS), no active extra-articular manifestations, normal levels of CRP and ESR [2]. The criteria for ASAS partial remission include a value not above 2 units in each of the 4 domains: patient global, pain, function, inflammation [1]. Results Initially, no patients met the ASAS partial remission clinical-laboratory criteria. At 3 year of follow-up, the clinical-laboratory remission was achieved by 21 (31.8%) patients; the ASAS partial remission - 29 (44.0%) patients. We matched patients who achieved the ASAS partial remission (n=29) to criteria for clinical-laboratory remission and, conversely, patients who achieved the clinical-laboratory remission (n=21) to criteria for ASAS partial remission. When comparing the criteria for clinical-laboratory remission to the group of patients who achieved the ASAS partial remission, it turned out that the criteria were achievable (more than 93%), the fewest patients with ASAS partial remission achieved BASDAI≤1.0 (75.8%) (graph 1). All patients with early axSpA who achieved clinical-laboratory remission met the ASAS criteria for partial remission (graph 1). Graph 1. Comparison of the clinical-laboratory remission and the ASAS partial remission in patients with axSpA at 3 y. of follow-up. Conclusion The criteria for clinical-laboratory remission are comparable to the ASAS criteria for partial remission in patients with early axSpA and can be used in a practice of rheumatologists. Further research is needed to analyze the various remission criteria for axSpA and their applicability in a practice. References [1]Anderson JJ, Baron G, van der Heijde D, Felson DT, Dougados M. Ankylosing spondylitis assessment group preliminary definition of short-term improvement in ankylosing spondylitis. Arthritis Rheum 2001;44:1876-86. [2]Gaidukova I.Z., Rebrov A.P., Korotaeva T.V., Dubinina T.V., Otteva E.N., Badokin V.V., Bochkova A.G., Bugrova O.V., Godzenko A.A., Dubikov A.I., Ivanova O.N., Lapshina S.A., Nesmeyanova O.B., Nikishina I.P., Raskina T.A., Rumyantseva O.A., Smirnov A.V., Sitalo A.V., Erdes S.F. REMISSION IN AXIAL SPONDYLOARTHRITIS: DEFINITION AND EVALUATION TOOLS (RECOMMENDATIONS OF THE SPONDYLOARTHRITIS STUDY GROUP OF EXPERTS, ALL-RUSSIAN PUBLIC ORGANIZATION «THE ASSOCIATION OF RHEUMATOLOGY OF RUSSIA»). Rheumatology Science and Practice. 2018;56(1):10-14. (In Russ.) https://doi.org/10.14412/1995-4484-2018-10-14 . Disclosure of Interests None declared